A nurse is caring for a child with spina bifida.
Which intervention is most important?

Choice A rationale

Limiting fluid intake is generally not indicated for atopic dermatitis unless there is a specific comorbid condition warranting fluid restriction. Maintaining adequate hydration is usually encouraged for overall skin health.

Choice B rationale

Promoting peeling of dead skin is not a primary goal in managing atopic dermatitis. The focus is on reducing inflammation, relieving itching, and maintaining skin hydration and barrier function, not necessarily on exfoliation.

Choice C rationale

Maintaining skin integrity and preventing infection are the most important goals in the care of a child with atopic dermatitis. The chronic inflammation and itching can lead to skin breakdown, increasing the risk of secondary bacterial or viral infections. Nursing interventions focus on gentle skin care, emollients, and managing itching.

Choice D rationale

Alcohol-based lotions should be avoided in children with atopic dermatitis as alcohol can dry and irritate the skin, exacerbating the condition and impairing skin integrity. Emollients that are fragrance-free and hypoallergenic are preferred to maintain skin hydration.

Choice A rationale

For a withdrawn 4-year-old, activities that allow for self-expression and communication are beneficial. Coloring provides a non-verbal outlet for emotions, and talking about feelings, facilitated by the nurse, can help the child process their experience and reduce feelings of isolation.

Choice B rationale

Practicing reading skills is developmentally appropriate for some 4-year-olds but may not be engaging or therapeutic for a child who is currently withdrawn and emotionally distressed due to hospitalization. The focus should be on emotional expression rather than academic tasks.

Choice C rationale

Watching cartoons alone can increase feelings of isolation and does not encourage interaction or emotional expression, which are crucial for a withdrawn child in a hospital setting.

Choice D rationale

While rest is important, frequent napping can further isolate the child and may not address the underlying emotional needs contributing to their withdrawal. Encouraging active engagement and interaction is more therapeutic.